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The Tico Times recently reported the Republic of Costa Rica increased its value-added tax (VAT) rate established in Law No. 9882.
Beginning on July 1, 2023, the local VAT was increased from 8% to 13% on the tourism industry.
The list of services for which VAT must be charged is available at the Ministry of Finance (www.hacienda.go.cr). A VAT is a consumption tax assessed on the value added in each good or service production stage.
The Association of Tourist Transporters of Costa Rica (ASTRONATUR) president describes it as “painful” for businesses and consumers, emphasizing that it will take a toll on the tourism sector’s finances.
Regarding health concerns, the U.S. CDC issued a Level 2 - Practice Enhanced Precautions Travel Health Notice in April 2023 regarding a malaria outbreak in Costa Rica.
Other Costa Rica travel news regarding vaccinations, safety, and malaria and dengue outbreaks is posted by Vax-Before-Travel.
The U.S. Centers for Disease Control and Prevention (CDC) recently expanded its Level 1 - Practice Usual Precautions, Travel Health Notice regarding measles outbreaks.
The CDC identified 38 countries with active measles outbreaks on June 29, 2023.
The leader is India, with over 73,000 measles cases.
Historically, measles outbreaks in the U.S. are rare, generally related to unvaccinated travelers. This year, the CDC has reported 15 measles cases in eleven jurisdictions.
Measles is caused by a highly contagious virus that spreads through the air by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. Furthermore, the measles virus can live for up to two hours in airspace after an infected person leaves an area.
And infected people can spread measles up to four days before and four days after a rash appears.
The good news is measles is a vaccine-preventable disease.
Approved measles vaccines are generally available at clinics and pharmacies in the U.S.
Reuters recently reported the European Commission secured purchase agreements with New York-based Pfizer Inc. and several European drugmakers to reserve the capacity to produce up to 325 million vaccines per year in case of a future global health emergency.
On June 30, 2023, Reuters confirmed this new agreement covers mRNA, vector-based and protein-based vaccines and does not relate to existing COVID-19 vaccine agreements.
The Commission helps to shape the European Union's (EU) overall strategy, proposes new laws and policies, monitors their implementation, and manages the budget. It also plays a significant role in supporting international development and delivering aid.
To facilitate safe free movement during the COVID-19 pandemic, the EU established the EU Digital COVID Certificate in 2023, based on the EU Global Health and World Health Organization (WHO) Global Strategies on digital health.
On July 1, 2023, the WHO took up the EU system of digital COVID-19 certification (passports) to establish a global system that will help protect citizens worldwide from on-going and future health threats, including pandemics.
The U.S. Embassy in Paris recently issued another Security Alert regarding demonstrations in the greater Paris region and other major urban centers in France.
As of June 30, 2023, the embassy is aware of potential security risks surrounding events expected to occur in Paris and the Paris region.
The embassy urges U.S. citizens to avoid these events and follow general guidelines regarding gatherings.
Previous Security Alerts can be found on this website.
The U.S. Embassy in Paris can be contacted at +33 (1) 43 12 22 22 or [email protected]. Additionally, U.S. citizens are encouraged to enroll in the Smart Traveler Enrollment Program to receive security updates from the Department of State.
As of June 2, 2023, the U.S. Department of State's Level 2 advisory says visitors to France should exercise increased caution due to civil unrest.
And incidents such as pickpocketing and phone snatchings occur frequently and can happen anywhere, especially in crowded areas such as airports, train stations, subway and train cars, and near tourist attractions.
As always, it is a good practice to notify friends or family of your whereabouts, says the U.S. government.
From a health perspective, the CDC suggests various travel vaccinations when visiting France in 2023.
This article was updated on June 3, 2023, with State Department reference and link.
Measles is an ongoing risk worldwide in the summer of 2023, often due to low vaccination rates, says the U.S. Centers for Disease Control and Prevention (CDC).
To alert travelers, the CDC recently reissued and expanded its Level 1 - Practice Usual Precautions, Global Measles Travel Health Notice.
On June 29, 2023, the CDC identified 38 countries with active measles outbreaks, which are declared when the number of cases is higher than expected.
The unfortunate leaders are India (73,536) and Yemen (19,312).
Historically, measles outbreaks in the U.S. are rare, generally related to unvaccinated travelers.
However, in 2019, 1,274 measles cases were confirmed in 31 U.S. states.
This year, the CDC reported 15 measles cases in jurisdictions such as Illinois, Kentucky, Ohio, and Utah.
Measles is caused by a highly contagious virus that spreads through the air by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes.
The measles virus can live for up to two hours in airspace after an infected person leaves an area.
People can spread measles up to four days before and four days after a rash.
Several groups are more likely to suffer from measles complications, including children younger than five years of age, pregnant women, and people with compromised immune systems, such as leukemia or HIV infection, says the CDC.
The good news is measles is a vaccine-preventable disease, and approved measles vaccines are generally available at health clinics and community pharmacies in the U.S.
Furthermore, the CDC suggests confirming with a healthcare provider international travelers need an extra measles vaccination before visiting an outbreak country.
The European Centre for Disease Prevention and Control (ECDC) recently reported the global cholera outbreak continues into the summer of 2023. While cholera in travelers is sporadic, outbreak settings do pose health risks.
The ECDC confirmed 412,137 cholera cases, including 2,130 related deaths, have been reported worldwide as of June 21, 2023.
In comparison, only 400 cholera deaths were reported during the same period in 2022.
In the Region of the Americas, Haiti continues to lead in cases and deaths.
Since January 2023 and as of early June 2023, over 26,000 cases, including 253 deaths, have been reported in Hati.
In comparison, in 2022, no cases were reported.
The good news is the island of Hispanola's eastern neighbor, the Dominican Republic, has reported very few cholera cases in 2023.
Visitors to Haiti should avoid unsafe food and water and wash their hands often to help prevent cholera, says the U.S. CDC.
Cholera is a vaccine-preventable disease. However, vaccination against cholera is not routinely recommended because most travelers do not visit areas of active transmission.
During 2023, cholera vaccines are in limited supply in the U.S.
The BMJ Journal recently published an Editorial confirming the rates of sexually transmitted infections (STI) are rising in Canada, the United Kingdom, and the United States (U.S.)
Published on June 30, 2023, these researchers stated ...We have the tools to respond (to these increases) and must deploy them urgently!
In June 2023, the U.K. Health Security Agency reported a 23.8% increase in STI diagnoses in 2022 compared with 2021, including chlamydia (24.3%), gonorrhea (50.3%), and syphilis (15.2%).
Similar trends have emerged in the U.S., where syphilis diagnoses rose by 28.6%.
And in Canada, where rates of syphilis rose by 20%.
This situation is important for a few reasons, wrote Patrick O’Byrne, full professor and nurse practitioner, University of Ottawa, School of Nursing, Lauren Orser, doctoral candidate, and Abigail Kroch, director, Ontario HIV Treatment Network.
Firstly, STIs cause harm, including pelvic inflammatory disease, disseminated gonococcal infection, and neurosyphilis.
Secondly, drug-resistant gonorrhea is now being reported internationally, showing the spread of antimicrobial resistance.
To read the full editorial, please visit this BMJ link.
Furthermore, there have been frequent reassurances of mpox cases and vaccine (JYNNEOS® (MVA-BN, IMVANEX®) breakthrough confirmations in 2023.
As of Ju;y 2023, mpox outbreaks have been identified in Chicago, Denver, London, New York, Paris, Seoul, and Tokyo.
In the U.S., the Food and Drug Administration has approved vaccines that can prevent certain sexually transmitted diseases caused by bacteria, viruses, or parasites. As of July 2, 2023, a STI vaccine overview was updated by Precision Vaccinations.
The U.S. Centers for Disease Control and Prevention (CDC) says polio is a vaccine-preventable disease that often impacts children. And to reduce poliovirus transmission, 31 countries have been administering a new vaccine in Africa.
Since 2022, the World Health Organization has recommended the nOPV2 vaccine when responding to circulating vaccine-derived poliovirus type 2 outbreaks in Africa.
As of late June 2023, over 670 million people have been vaccinated with this vaccine.
This single-dose vaccine has been 'triple-locked' using genetic engineering to prevent it from becoming harmful. As a result, nOPV2 is reported to be genetically more stable than existing oral polio vaccines, with a lower risk of reversion to neurovirulence.
As of July 1, 2023, the nOPV2 vaccine is not offered in the U.S.
The Global Polio Eradication Initiative recently published nOPV2 Frequently Asked Questions, Fact Sheet, and polio outbreak country list.
And the WHO reconfirmed on May 12, 2023, poliovirus outbreaks remained a Public Health Emergency of International Concern.
